Healthcare Provider Details

I. General information

NPI: 1578710083
Provider Name (Legal Business Name): EMMA E CASTILLO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMA ESTHER SALAZAR DDS

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALDAMA 830 ZONA CENTRO
REYNOSA TAMAULIPAS
88500
MX

IV. Provider business mailing address

4708 SANDPIPER AVE
MCALLEN TX
78504-2142
US

V. Phone/Fax

Practice location:
  • Phone: 899-922-0232
  • Fax:
Mailing address:
  • Phone: 956-467-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2928300
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: